Cancer Screening: Reducing Client Out-of-Pocket Costs — Breast Cancer
Findings and Recommendations
The Community Preventive Services Task Force (CPSTF) recommends reducing client out-of-pocket costs for breast cancer screening on the basis of sufficient evidence of effectiveness in increasing screening for breast cancer.
The full CPSTF Finding and Rationale Statement and supporting documents for Cancer Screening: Reducing Client Out-of-Pocket Costs — Breast Cancer are available in The Community Guide Collection on CDC Stacks.
Intervention
Interventions to reduce client out-of-pocket costs attempt to minimize or remove economic barriers that make it difficult for clients to access cancer screening services. Costs can be reduced through a variety of approaches, including vouchers, reimbursements, reduction in co-pays, or adjustments in federal or state insurance coverage. Efforts to reduce client costs may be combined with measures to provide client education, information about program availability, or measures to reduce structural barriers.
About The Systematic Review
The CPSTF finding is based on evidence from a Community Guide systematic review published in 2008 (Baron et al., 8 studies, search period 1966-2004) combined with more recent evidence (0 studies, search period 2004-2008).
Study Characteristics
No qualifying studies were identified during the updated search period.
Summary of Results
Eight studies qualified for the original systematic review; no new studies were identified for the update.
- Mammography screening: median increase of 11.5 percentage points (interquartile interval: 6.0 to 28.5 percentage points; 8 studies)
Summary of Economic Evidence
An economic review of this intervention did not find any relevant studies.
Applicability
Findings should be applicable to various populations and settings in which people would accept screening but have limited financial resources.
Evidence Gaps
The following outlines evidence gaps for reducing client out-of-pocket costs to increase breast, cervical, or colorectal cancer screening.
- Are interventions effective for promoting colorectal cancer screening with methods other than FOBT?
- Are interventions to promote colorectal cancer screening equally effective when addressing colorectal cancer screening more generally, as when specific to one type of test?
- What are the incremental effects of adding intervention components to other interventions?
- What influence do newer methods of communication (e.g., the Internet, e-mail, social media, automated interactive voice response, texting) have on intervention effectiveness?
- What is the influence of health system factors on intervention effectiveness?
Implementation Considerations and Resources
- To increase awareness and use of covered services, it is important to promote these programs and policies to both patients and providers
- Broad programs and policies that reduce out-of-pocket costs to increase breast cancer screening should coordinate follow-up for patients without regular care
Crosswalks
Find programs from the EBCCP website that align with this systematic review. (What is EBCCP?)
Healthy People 2030 includes the following objectives related to this CPSTF recommendation.